Is my cat coming to the end of his life?

[CustardCream74]

He's 17 with thyroid problems. Been on medication for this for years and is now on just about the maximum dose.
Over the last 10 months or so he is gradually losing weight and now quite skinny. The vet wants him to have bloods done to see what the issue is. I have refused as at this stage of his life as it is traumatising for him and I wouldn't put him through anything else anyway.
This last 2 weeks his behaviour has changed. His appetite is ravenous. He literally scoffs 1 pouch then begs for another. (he has continuous dry food available but doesn't eat much) He yowls, runs into your legs, scratches the food cupboard.....anything to try and get you to feed him again. He is already on 4 pouches a day. This behaviour goes on and on. He still wanders around outside and has a catflap He goes in and out and in and out hoping each time his bowl will miraculously fill itself even though it is 10 minutes since his previous meal.
He does eventually give up and then sits/lies on the landing or the doorway. Not comfy on the beds like he used to most of the day. He does occasionally settle down and snuggle but I would say that 70% of time he is just miaowing for food. I hope he isn't suffering obviously and I don't know what to do for the best. When he is snuggled up to me purring and is settled on the bed it seems wrong to be thinking of putting him to sleep.
Any vet/vet nurses able to offer any advice?

Is he drinking and peeing ?

Why won’t you agree to bloods? Surely they are a regular requirement for medicating thyroid issues in cats (it was the reason we opted for radiation treatment, to avoid them so often).

Have you increased his food in line with his appetite?

Thyroid and kidney problems are issues with very senior cats. Is he drinking and weeing ok? Speak to your vet again - a quick blood test would give you a better idea of what's going on and how best to manage his health decline.

If he's permanently hungry and can't settle then that sounds like a poor quality of life. I'm pretty brutal about these things but he sounds old and unhappy. Yes you can get bloods etc but he's going to suffer while you wait for the results etc and it could be there's nothing you can do.

Yes he is drinking and peeing fine. I have refused bloods because he goes berserk having it done and whatever the outcome I am not putting him through anything invasive. He can't have anymore thyroid meds than he is already on. I am at the point where I know he won't last much longer but it's really hard to know when exactly that moment is.

Your cat is very obviously unregulated with his thyroid. Most common symptoms of hyperthyroidism are increased appetite (ravenous is what most people usually describe it as), drinking more, urinating more, losing weight (despite eating more) and restlessness. Some cats may even become aggressive. Your cat is exhibiting most if not all of these.

Basically what the hyperactive thyroid does is increase his metabolism. That means that it increases his blood pressure, heart rate and digestion. If it stays uncontrolled for long periods of time it can lead to chronic issues (ie blindness due to the BP being so high and the little vessels in his eyes bursting, heart disease, kidney problems etc).

When it comes to the medication, there is a "maximum" dose in the sense that the company has only tested it up to this dose. Anything beyond this dose hasn't been tested and so no vet can tell you how safe it's going to be to be using long term. At 17, he's likely coming to the end of his natural life anyway, so I'd probably take the risk myself, but ultimately that's a decision for yourself and your vet to make (also up to your vet how comfortable they'd be to increase the dose without bloods and going just on clinical signs).

Being hyperthyroid is not a nice feeling (think constant racing heart and feeling hungry all the time), so I always recommend if you're not going to treat kindest thing is to let them go, as you wouldn't want them to be living like this (plus the risks of all the possible complications I mentioned earlier). So I would recommend a visit to your vet, discuss dose adjustments (with or without bloods, your vet will be the best to help you decide what's best/safest for your cat) and if that's not an option, then yes I would say letting him go is a very valid option.

Best of luck to you and your kitty!

I'd say arthritis is preventing him jumping onto the beds etc. The food issue sounds like a very common symptom of dementia to me - have you noticed he's worse at night? Tbh I'd probably have him pts as dementia is quite distressing and I'd want to avoid further suffering.

I’m surprised the vet won’t do a gentle sedation to help with the bloods if you cat finds them that distressing. Are you feeding more?

If you aren’t going to allow tests to see if there is something underlying, then now probably is the right time to euthanise given your description above.

My cat doesn't have dry food so is on 4-6 pouches a day, so he might be genuinely hungry if he's not having dried food.

The only way to know what's going on for sure is bloodwork. IMHO it's far more cruel to refuse bloodwork and keep him alive without knowing what's going on than it is to put him through the slight distress of having it done.

If you are not ready to let him go, I'd urge you to get the blood work done.

However, the fact that he deliberately spends his time in uncomfortable places (rather than available beds) suggests that he is trying to detract himself from discomfort.

I'm sure you don't want to let him suffer. Remember that cats have no sense of tomorrow. He will have had a good life until recently - I think it's time to let him go. Better a day too soon... 💐

My cat was exactly the same before we got the right level of thyroid medication for her. Can the vet increase meds and book him in for bloods in a few weeks?

Agreed. All in all it might be better for your cat to be let go. His quality of life is really awful.

Vet won't increase meds as he's on the highest dose they are prepared to give him. If I thought having his bloods done would help him it would be worth the distress but my point is it won't change anything with his medication as he can't have more and it's too late for other options now.

So he currently is snuggled on my bed asleep after 45 minutes of begging for me to feed him. He purrs happily when I stroke him which makes it so hard

My cat went through the same before he died, including the weight loss and thyroid issues. I wouldn't imagine he has very much longer left.

If your vet won't increase the meds with or without bloods then I agree bloods are pointless as your cat is almost certainly uncontrolled. In this case you have two options, you either speak to your vet or look for a different vet (one that might be open to go "off license" and give you a higher dose of meds, as long as you understand the risks/limitations of doing so as there is limited info available on the safety of doing so and also highly likely that the new dose will only work for a short period of time before your cat becomes uncontrolled again) or you let him go. I wouldn't leave him at current dose as obviously not controlled and only one way this is going to end.

My cat has been doing the same. He was diagnosed with cancer three days ago.

Cats are very good at self- soothing and often distract themselves from pain by purring.

Sorry for the massive drip feed I totally forgot well over a year ago (I cannot remember the date) he developed a lump and we had it removed. The op nearly killed him and that is 1 of the reasons why I won't put him through anymore treatment but the vet said the lump had some malignancy. We never found out exactly as I couldn't afford to pay the extra to do so after paying for the op. So it may well be related. I can't believe I forgot about that. That's menopause for you I guess!

Our last cat was similar and then one day I found her just sitting on her dads laundry pile and unable to really move and it was time , that decline happened really within a couple of days so just keep an eye on him and get lots of cuddles

Happened to mine, similar age about 3 years ago

Kidney failure. (as well as overactive thyroid)

She refused a special diet so had cooked chicken or fish (protein still too much) as we wanted her to enjoy the remainder of her time. Loved her thyroid medication

She drank like a fish but whilst she was fine in herself and loved sitting with us in the evening and wandering the garden we carried on with the vets agreement

She was getting thinner but still loving a cuddle. Then I noticed she couldn't get upstairs any more on her own but could still get on the sofa and the bed

Then came the day when she absolutely wasn't herself. Wasn't moving much. Couldn't jump up. Next day we think she had a stroke.

So that was the time 😢

My cat had this when he had liver problems due to a toxic build up in his
Brain. The vet agreed the food obsession was bad - he nearly jumped out their crate after food.

Look in cats mouth see if gums are yellow - this will indicate a liver problem. I'd go to vets and explain how bad he is. My cat had a drip and antibiotics and recovered z

I would be feeding him as much as he wants.
If he is on supermarket pouches they aren't too substantial in terms of protein etc and I would give him a really lovely week with you and then consider sending him to heaven.

My cats are my life, but I strongly believe that at a certain age and if they are distressed then the kindest thing is to help them move on.

You can get lovely mobile vets that come to your home now, he can sit with you on the sofa and pass peacefully and they will take him when you are ready vs having to stress him out by taking him into the vet.

Unregulated thyroid is a horrible feeling and I personally wouldn't leave my cat feeling awful for too long.

Lots of food and treats and then a peaceful goodbye.

You sound lovely and I am so sorry you have to make this decision. It is the worst thing ever 💗

If it is a high dose of thyroxine that he takes every day then might it not be that you need to decrease the medication rather than increase it?

High thyroxine levels increase the metabolism, causing ravenous hunger that often cannot be satisfied, and often weight loss and/or some muscle wastage. The only way you will know whether a simple measure like that could be effective is to have the blood tests done.

Having blood tests done does not mean that you are going to go down the invasive surgery route, but it will provide information on whether or not his medication dose could possibly be too high. In which case then surely, under advice from the vet, you could just try reducing it a little and seeing how things go. That in itself is hardly an invasive procedure.

Light sedation could be used to minimise distress when taking the blood samples.

I think that is what I would do first, but if that had no effect and/or he continued to decline then I would have to consider that the end was approaching. I'm sorry that probably sounds brutal, but there is no easy way to say it.

I'm sorry you are going through this. It is a very difficult time. All of us who have had pets have been there at some point, and I very clearly remember the last days and weeks with my three (two dogs and a cat). The feeling of being on borrowed time was very stressful and strong.